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Youth Panel - Nomination Form
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1.
Please confirm you have the nominees permission to nominate them for the 2022 Youth Panel:
(Required.)
Yes, I have their permission
No, I do not have their permission
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2.
To nominate someone for the Youth Panel, firstly please provide your (the nominators) contact information:
(Required.)
First name
Surname
Phone number
Email address
How do you know the nominee?
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3.
Please indicate which local government area that the nominee lives (if you are unsure, visit www.lgat.tas.gov.au).
(Required.)
Waratah-Wynyard
Burnie
Central Coast
Kentish
Meander
Northern Midlands
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4.
Please provide the nominees contact information:
(Required.)
First name
Surname
Age
Suburb/Town
Phone number
Email address
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5.
Why would you like to nominate this person for the Youth Panel?
(Required.)
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6.
What, if any, support do you think the nominee will need to get the most out of this opportunity?
(Required.)
Current Progress,
0 of 6 answered
